Provider Demographics
NPI:1619190311
Name:SIMMS, LESLEY ANN (COTA)
Entity Type:Individual
Prefix:MISS
First Name:LESLEY
Middle Name:ANN
Last Name:SIMMS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 DUNBAR AVE
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2038
Mailing Address - Country:US
Mailing Address - Phone:304-252-0257
Mailing Address - Fax:
Practice Address - Street 1:110 DUNBAR AVE
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2038
Practice Address - Country:US
Practice Address - Phone:304-252-0257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1518224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant